Clinical Inquiries Received by CDC Regarding Suspected Ebola Virus Disease in Children — United States, July 9, 2014–January 4, 2015
The 2014–2015 Ebola virus disease (Ebola) epidemic is the largest in history and represents the first time Ebola has been diagnosed in the United States. On July 9, 2014, CDC activated its Emergency Operations Center and established an Ebola clinical consultation service to assist U.S. state and loc...
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creator | Goodman, Alyson B. Meites, Elissa Anstey, Erica H. Fullerton, Kathleen E. Jayatilleke, Achala Ruben, Wendy Koumans, Emily Oster, Alexandra M. Karwowski, Mateusz P. Dziuban, Eric Kirkcaldy, Robert D. Glover, Maleeka Lowe, Luis Peacock, Georgina Mahon, Barbara Griese, Stephanie E. |
description | The 2014–2015 Ebola virus disease (Ebola) epidemic is the largest in history and represents the first time Ebola has been diagnosed in the United States. On July 9, 2014, CDC activated its Emergency Operations Center and established an Ebola clinical consultation service to assist U.S. state and local public health officials and health care providers with the evaluation of suspected cases. CDC reviewed all 89 inquiries received by the consultation service during July 9, 2014– January 4, 2015, about children (persons aged ≤18 years). Most (56 [63%]) children had no identifiable epidemiologic risk factors for Ebola; among the 33 (37%) who did have an epidemiologic risk factor, in every case this was travel from an Ebola-affected country. Thirty-two of these children met criteria for a person under investigation (PUI) because of clinical signs or symptoms. Fifteen PUIs had blood samples tested for Ebola virus RNA by reverse transcription–polymerase chain reaction; all tested negative. Febrile children who have recently traveled from an Ebola-affected country can be expected to have other common diagnoses, such as malaria and influenza, and in the absence of epidemiologic risk factors for Ebola, the likelihood of Ebola is extremely low. Delaying evaluation and treatment for these other more common illnesses might lead to poorer clinical outcomes. Additionally, many health care providers expressed concerns about whether and how parents should be allowed in the isolation room. While maintaining an appropriate level of vigilance for Ebola, public health officials and health care providers should ensure that pediatric PUIs receive timely triage, diagnosis, and treatment of other more common illnesses, and care reflecting best practices in supporting children’s psychosocial needs. |
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On July 9, 2014, CDC activated its Emergency Operations Center and established an Ebola clinical consultation service to assist U.S. state and local public health officials and health care providers with the evaluation of suspected cases. CDC reviewed all 89 inquiries received by the consultation service during July 9, 2014– January 4, 2015, about children (persons aged ≤18 years). Most (56 [63%]) children had no identifiable epidemiologic risk factors for Ebola; among the 33 (37%) who did have an epidemiologic risk factor, in every case this was travel from an Ebola-affected country. Thirty-two of these children met criteria for a person under investigation (PUI) because of clinical signs or symptoms. Fifteen PUIs had blood samples tested for Ebola virus RNA by reverse transcription–polymerase chain reaction; all tested negative. Febrile children who have recently traveled from an Ebola-affected country can be expected to have other common diagnoses, such as malaria and influenza, and in the absence of epidemiologic risk factors for Ebola, the likelihood of Ebola is extremely low. Delaying evaluation and treatment for these other more common illnesses might lead to poorer clinical outcomes. Additionally, many health care providers expressed concerns about whether and how parents should be allowed in the isolation room. While maintaining an appropriate level of vigilance for Ebola, public health officials and health care providers should ensure that pediatric PUIs receive timely triage, diagnosis, and treatment of other more common illnesses, and care reflecting best practices in supporting children’s psychosocial needs.</description><identifier>ISSN: 0149-2195</identifier><identifier>EISSN: 1545-861X</identifier><identifier>DOI: 10.15585/mmwr.mm6436a3</identifier><identifier>PMID: 26390343</identifier><language>eng</language><publisher>United States: Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services</publisher><subject>Adolescent ; Centers for Disease Control and Prevention (U.S.) - utilization ; Child ; Child, Preschool ; Children ; Diagnosis ; Diagnosis, Differential ; Diseases ; Ebola virus ; Ebola virus infections ; Ebolavirus - isolation & purification ; Epidemics ; Female ; Health care industry ; Health Facilities ; Health Personnel ; Hemorrhagic Fever, Ebola - diagnosis ; Hemorrhagic Fever, Ebola - epidemiology ; Humans ; Infant ; Infant, Newborn ; International economic relations ; Male ; Public health ; Remote Consultation - statistics & numerical data ; Risk Factors ; United States - epidemiology</subject><ispartof>MMWR. Morbidity and mortality weekly report, 2015-09, Vol.64 (36), p.1006-1010</ispartof><rights>COPYRIGHT 2015 U.S. Government Printing Office</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-1c0cd433068f64fb2ce3b3ad3d1039507008f9a5260aab7f074f75c3098f33cc3</citedby><cites>FETCH-LOGICAL-c526t-1c0cd433068f64fb2ce3b3ad3d1039507008f9a5260aab7f074f75c3098f33cc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/24856780$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/24856780$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27901,27902,57992,58225</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26390343$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goodman, Alyson B.</creatorcontrib><creatorcontrib>Meites, Elissa</creatorcontrib><creatorcontrib>Anstey, Erica H.</creatorcontrib><creatorcontrib>Fullerton, Kathleen E.</creatorcontrib><creatorcontrib>Jayatilleke, Achala</creatorcontrib><creatorcontrib>Ruben, Wendy</creatorcontrib><creatorcontrib>Koumans, Emily</creatorcontrib><creatorcontrib>Oster, Alexandra M.</creatorcontrib><creatorcontrib>Karwowski, Mateusz P.</creatorcontrib><creatorcontrib>Dziuban, Eric</creatorcontrib><creatorcontrib>Kirkcaldy, Robert D.</creatorcontrib><creatorcontrib>Glover, Maleeka</creatorcontrib><creatorcontrib>Lowe, Luis</creatorcontrib><creatorcontrib>Peacock, Georgina</creatorcontrib><creatorcontrib>Mahon, Barbara</creatorcontrib><creatorcontrib>Griese, Stephanie E.</creatorcontrib><title>Clinical Inquiries Received by CDC Regarding Suspected Ebola Virus Disease in Children — United States, July 9, 2014–January 4, 2015</title><title>MMWR. Morbidity and mortality weekly report</title><addtitle>MMWR Morb Mortal Wkly Rep</addtitle><description>The 2014–2015 Ebola virus disease (Ebola) epidemic is the largest in history and represents the first time Ebola has been diagnosed in the United States. On July 9, 2014, CDC activated its Emergency Operations Center and established an Ebola clinical consultation service to assist U.S. state and local public health officials and health care providers with the evaluation of suspected cases. CDC reviewed all 89 inquiries received by the consultation service during July 9, 2014– January 4, 2015, about children (persons aged ≤18 years). Most (56 [63%]) children had no identifiable epidemiologic risk factors for Ebola; among the 33 (37%) who did have an epidemiologic risk factor, in every case this was travel from an Ebola-affected country. Thirty-two of these children met criteria for a person under investigation (PUI) because of clinical signs or symptoms. Fifteen PUIs had blood samples tested for Ebola virus RNA by reverse transcription–polymerase chain reaction; all tested negative. Febrile children who have recently traveled from an Ebola-affected country can be expected to have other common diagnoses, such as malaria and influenza, and in the absence of epidemiologic risk factors for Ebola, the likelihood of Ebola is extremely low. Delaying evaluation and treatment for these other more common illnesses might lead to poorer clinical outcomes. Additionally, many health care providers expressed concerns about whether and how parents should be allowed in the isolation room. While maintaining an appropriate level of vigilance for Ebola, public health officials and health care providers should ensure that pediatric PUIs receive timely triage, diagnosis, and treatment of other more common illnesses, and care reflecting best practices in supporting children’s psychosocial needs.</description><subject>Adolescent</subject><subject>Centers for Disease Control and Prevention (U.S.) - utilization</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Diagnosis</subject><subject>Diagnosis, Differential</subject><subject>Diseases</subject><subject>Ebola virus</subject><subject>Ebola virus infections</subject><subject>Ebolavirus - isolation & purification</subject><subject>Epidemics</subject><subject>Female</subject><subject>Health care industry</subject><subject>Health Facilities</subject><subject>Health Personnel</subject><subject>Hemorrhagic Fever, Ebola - diagnosis</subject><subject>Hemorrhagic Fever, Ebola - epidemiology</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>International economic relations</subject><subject>Male</subject><subject>Public health</subject><subject>Remote Consultation - statistics & numerical data</subject><subject>Risk Factors</subject><subject>United States - epidemiology</subject><issn>0149-2195</issn><issn>1545-861X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0k9vFCEUAHBiNLZWr940JE2Mh84KAwwzx2ZatU0TE2uNtwnDPHZpGGYLM5q99ehdP2E_iWy39U-yB-FAePzeC4GH0HNKZlSIUrzp-29h1vcFZ4ViD9AuFVxkZUG_PES7hPIqy2kldtCTGC_JejDyGO3kBasI42wXfa-d9VYrh0_81WSDhYg_ggb7FTrcrnB9VKf9XIXO-jk-n-IS9JiOjtvBKfzZhiniIxtBRcDW43phXRfA45vrn_jC2zU9H9UI8QCfTm6FqwOcp2vdXP84VX5SYYX5bUQ8RY-MchGe3a176OLt8af6fXb24d1JfXiWaZEXY0Y10R1njBSlKbhpcw2sZapjHSWsEkQSUppKJUuUaqUhkhspNCNVaRjTmu2h15u6yzBcTRDHprdRg3PKwzDFhspcFlJwKv-DUlFRSXiZ6P6GzpWDxnozjEHpNW8OeV5JJkrKk8q2qDl4CMoNHoxN4X_8bItPs4Pe6q0Jr_5KWIBy4yIObhrt4OPWyjoMMQYwzTLYPn1HQ0lz21jNurGa-8ZKCS_v3mJqe-h-8_tOSuDFBlzGcQh_znkpClkS9gtaPNA9</recordid><startdate>20150918</startdate><enddate>20150918</enddate><creator>Goodman, Alyson B.</creator><creator>Meites, Elissa</creator><creator>Anstey, Erica H.</creator><creator>Fullerton, Kathleen E.</creator><creator>Jayatilleke, Achala</creator><creator>Ruben, Wendy</creator><creator>Koumans, Emily</creator><creator>Oster, Alexandra M.</creator><creator>Karwowski, Mateusz P.</creator><creator>Dziuban, Eric</creator><creator>Kirkcaldy, Robert D.</creator><creator>Glover, Maleeka</creator><creator>Lowe, Luis</creator><creator>Peacock, Georgina</creator><creator>Mahon, Barbara</creator><creator>Griese, Stephanie E.</creator><general>Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services</general><general>U.S. Government Printing Office</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>20150918</creationdate><title>Clinical Inquiries Received by CDC Regarding Suspected Ebola Virus Disease in Children — United States, July 9, 2014–January 4, 2015</title><author>Goodman, Alyson B. ; 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Morbidity and mortality weekly report</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goodman, Alyson B.</au><au>Meites, Elissa</au><au>Anstey, Erica H.</au><au>Fullerton, Kathleen E.</au><au>Jayatilleke, Achala</au><au>Ruben, Wendy</au><au>Koumans, Emily</au><au>Oster, Alexandra M.</au><au>Karwowski, Mateusz P.</au><au>Dziuban, Eric</au><au>Kirkcaldy, Robert D.</au><au>Glover, Maleeka</au><au>Lowe, Luis</au><au>Peacock, Georgina</au><au>Mahon, Barbara</au><au>Griese, Stephanie E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Inquiries Received by CDC Regarding Suspected Ebola Virus Disease in Children — United States, July 9, 2014–January 4, 2015</atitle><jtitle>MMWR. Morbidity and mortality weekly report</jtitle><addtitle>MMWR Morb Mortal Wkly Rep</addtitle><date>2015-09-18</date><risdate>2015</risdate><volume>64</volume><issue>36</issue><spage>1006</spage><epage>1010</epage><pages>1006-1010</pages><issn>0149-2195</issn><eissn>1545-861X</eissn><abstract>The 2014–2015 Ebola virus disease (Ebola) epidemic is the largest in history and represents the first time Ebola has been diagnosed in the United States. On July 9, 2014, CDC activated its Emergency Operations Center and established an Ebola clinical consultation service to assist U.S. state and local public health officials and health care providers with the evaluation of suspected cases. CDC reviewed all 89 inquiries received by the consultation service during July 9, 2014– January 4, 2015, about children (persons aged ≤18 years). Most (56 [63%]) children had no identifiable epidemiologic risk factors for Ebola; among the 33 (37%) who did have an epidemiologic risk factor, in every case this was travel from an Ebola-affected country. Thirty-two of these children met criteria for a person under investigation (PUI) because of clinical signs or symptoms. Fifteen PUIs had blood samples tested for Ebola virus RNA by reverse transcription–polymerase chain reaction; all tested negative. Febrile children who have recently traveled from an Ebola-affected country can be expected to have other common diagnoses, such as malaria and influenza, and in the absence of epidemiologic risk factors for Ebola, the likelihood of Ebola is extremely low. Delaying evaluation and treatment for these other more common illnesses might lead to poorer clinical outcomes. Additionally, many health care providers expressed concerns about whether and how parents should be allowed in the isolation room. While maintaining an appropriate level of vigilance for Ebola, public health officials and health care providers should ensure that pediatric PUIs receive timely triage, diagnosis, and treatment of other more common illnesses, and care reflecting best practices in supporting children’s psychosocial needs.</abstract><cop>United States</cop><pub>Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services</pub><pmid>26390343</pmid><doi>10.15585/mmwr.mm6436a3</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adolescent Centers for Disease Control and Prevention (U.S.) - utilization Child Child, Preschool Children Diagnosis Diagnosis, Differential Diseases Ebola virus Ebola virus infections Ebolavirus - isolation & purification Epidemics Female Health care industry Health Facilities Health Personnel Hemorrhagic Fever, Ebola - diagnosis Hemorrhagic Fever, Ebola - epidemiology Humans Infant Infant, Newborn International economic relations Male Public health Remote Consultation - statistics & numerical data Risk Factors United States - epidemiology |
title | Clinical Inquiries Received by CDC Regarding Suspected Ebola Virus Disease in Children — United States, July 9, 2014–January 4, 2015 |
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